Lin Li1, Yanfeng Zhao1, Dehong Luo1, Liang Yang2, Lei Hu1, Xinming Zhao1, Yong Wang3, Wensheng Liu4. 1. Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. 2. Department of Diagnostic Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China. 3. Department of Ultrasonography, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. 4. Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Abstract
BACKGROUND: An accurate preoperative diagnosis that helps distinguish between benign and malignant parotid gland tumors is very important because the results strongly affect surgical procedures. We aimed to evaluate the value of single-source dual-energy computed tomography (ssDECT) in differentiating malignant from benign parotid gland tumors. METHODS: Fifty patients underwent enhanced neck ssDECT scanning before surgery. The images were analyzed using the gemstone spectral imaging (GSI) viewer software. RESULTS: Fifty-two tumors (43 patients) were confirmed histopathologically, comprising of 12 pleomorphic adenomas (PAs), 24 Warthin tumors (WTs) (15 patients), and 16 malignant tumors (MTs). The iodine concentration (IC), normalized iodine concentration to common carotid artery (NICA) and slope value of the spectral curve (λHU) of the WTs were significantly higher than those of MTs and PAs (all P<0.05). The optimal IC, NICA and λHU thresholds for differentiating PAs from MTs were 0.91 mg/mL, 0.15 and 1.09, respectively, achieving sensitivities of 91.7%, 91.7% and 91.7%, specificities of 95.0%, 85.0% and 95.0%, and accuracies of 94.2%, 86.5% and 94.2%, respectively for distinguishing PAs from MTs. The optimal IC, NICA and λHU thresholds for distinguishing WTs from MTs were 1.46 mg/mL, 0.20 and 1.72, achieving sensitivities of 91.7%, 95.8% and 91.7%, and specificities of 89.3%, 85.7% and 89.3%, respectively. The accuracy was 90.4%, 90.4% and 90.4%, respectively. CONCLUSIONS: The parameters of ssDECT in enhanced CT scans are useful in the differential diagnosis of parotid tumors.
BACKGROUND: An accurate preoperative diagnosis that helps distinguish between benign and malignant parotid gland tumors is very important because the results strongly affect surgical procedures. We aimed to evaluate the value of single-source dual-energy computed tomography (ssDECT) in differentiating malignant from benign parotid gland tumors. METHODS: Fifty patients underwent enhanced neck ssDECT scanning before surgery. The images were analyzed using the gemstone spectral imaging (GSI) viewer software. RESULTS: Fifty-two tumors (43 patients) were confirmed histopathologically, comprising of 12 pleomorphic adenomas (PAs), 24 Warthin tumors (WTs) (15 patients), and 16 malignant tumors (MTs). The iodine concentration (IC), normalized iodine concentration to common carotid artery (NICA) and slope value of the spectral curve (λHU) of the WTs were significantly higher than those of MTs and PAs (all P<0.05). The optimal IC, NICA and λHU thresholds for differentiating PAs from MTs were 0.91 mg/mL, 0.15 and 1.09, respectively, achieving sensitivities of 91.7%, 91.7% and 91.7%, specificities of 95.0%, 85.0% and 95.0%, and accuracies of 94.2%, 86.5% and 94.2%, respectively for distinguishing PAs from MTs. The optimal IC, NICA and λHU thresholds for distinguishing WTs from MTs were 1.46 mg/mL, 0.20 and 1.72, achieving sensitivities of 91.7%, 95.8% and 91.7%, and specificities of 89.3%, 85.7% and 89.3%, respectively. The accuracy was 90.4%, 90.4% and 90.4%, respectively. CONCLUSIONS: The parameters of ssDECT in enhanced CT scans are useful in the differential diagnosis of parotid tumors.
Authors: Courtney A Coursey; Rendon C Nelson; Daniel T Boll; Erik K Paulson; Lisa M Ho; Amy M Neville; Daniele Marin; Rajan T Gupta; Sebastian T Schindera Journal: Radiographics Date: 2010 Jul-Aug Impact factor: 5.333